The overall incidence of substance abuse is stable for all drugs except cocaine which is steadily increasing in popularity in all aspects of the population. Signs of neonatal abstinence are seen to varying degrees in infants exposed to any of the drugs of abuse. Polydrug use by pregnant women is the most common form of substance abuse, and this complicates the evaluation of the newborn infant. Infants exposed in utero to cocaine are markedly tremulous and irritable and have an increased rate of prematurity. All infants delivered to substance-abusing mothers should be considered at increased risk for sudden infant death syndrome and evaluated accordingly.

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